GP Revision

personal independent payment is a SOCIAL POLICY

chemical = chemical substance e.g. during work causing inflammed hands

physical = environment causing harm/diseases

direct question would ask for something specific, would lead to a specific answer

closed question = yes/no

leading question = answer embedded in question

reflective question = reflect back onto patient

body languages

leaning backwards = not listening

leaning forwards = listening well

poor eye contact = low mood, depressed

smiling = happy

changes

avoiding social events = behavioural

depression = mental health/mood

headaches = physical symptom of stress

another is palpitations, tremors, excessive shaking (physical symptoms of stress)

isolation from friends and family = behavioural

low mood = mental health

60 year old man has a dry cough for 6 months. He is an ex smoker. There is no haemoptysis. His examination was unremarkable. He lost 6kgs in the last 3 months. What is the most appropriate investigation that his GP should request?

-fits criteria for urgent suspected cancer so answer is Urgent chest X-ray (got correct)

cough for 3 weeks or longer consider for chest xray

dyspnoea, weight loss, chest signs

risk and uncertainty lecture slides 36-37

30 year old woman sees her GP. The GP calls her from the waiting room and noted that she is limping. He says: ' I'm really sorry to see you in pain, would you like me to get a wheelchair for you'? Which Roger Neighbour checkpoint this may represent?

doctor establishing rapport = connecting with patient (answer, got correct)

summarising after all info gathering and examination

handover after all that telling patient like conclusion, management plan

safety netting is telling patient what to do if for example they have chest pain or SOB, come back to see doctor

house keeping, knowing how to hold the consultation e.g. break or a drink if you had a angry patient, tidying up to be ready for next patient physically and mentally

70 year old man with history of a productive cough for one week. His temperature is 38.5, Respiratory rate is 20/minute. He has crackles on the right lower lung fields. He is not confused and has no known allergies. The GP diagnosis community acquired lower respiratory tract infection. What is the most appropriate next step?

prescribe amoxicillin (correct answer, got right), need diagnosis of LRTI

do CURB65 as pneumonia is a type of lower respiratory tract infection

stem says has no allergies so amoxicillin is fine

if he had red flags you could refer for urgent chest xray

72 year old man has central chest pain for the last hour. The pain radiates to his neck. He used GTN spray twice with no relief. He is sweaty and clammy. What would be the most appropriate action?

call 999 (correct answer, got right)

having an MI so hospital immediately

taking GTN again wouldn’t help, taking indigestion medication wouldn’t help